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A personalized approach to assessing and managing Pain in Patients with Cancer

David Hui and Eduardo Bruera

Journal of Clinical Oncology, 2014; 32: 1640-1646 

Editors' commentsDr. Carla Ripamonti

Pain is a frequent and impacting symptom not only in advanced cancer but in any phase of the disease. Pain can be caused by cancer itself, co-morbidities; it may result following surgery, radiotherapy, chemotherapy, targeted therapy , supportive care treatments and/or diagnostic procedures or it may be unrelated to cancer. Pain has been defined as the fifth vital sign by the American Pain Society and its routine assessment is emphasized by international guidelines. Poor pain assessment is the greatest barrier to effective cancer pain management. To be adequately treated, cancer pain needs to be identified, assessed, classified and managed with a multistep approach that includes “ systematic screening, comprehensive pain assessment, characterization of pain, identification of personal modulators of pain expression, documentation of personalized pain goals, and implementation of multidisciplinary treatment plan with subsequent customized longitudinal monitoring”.
The review of the Authors should be considered the golden standard for the assessment of pain for all the physicians who take care for cancer patients at any stage of the disease.